Provider Demographics
NPI:1912399882
Name:DUNCAN, MAKESI (OTR/L)
Entity Type:Individual
Prefix:
First Name:MAKESI
Middle Name:
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 JACKSON AVE
Mailing Address - Street 2:APT 2
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-5422
Mailing Address - Country:US
Mailing Address - Phone:347-752-2128
Mailing Address - Fax:
Practice Address - Street 1:1108 JACKSON AVE
Practice Address - Street 2:APT 2
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-5422
Practice Address - Country:US
Practice Address - Phone:347-752-2128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018399225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist